| Cigna + Oscar |
| everolimus (antineoplastic) (everolimus (antineoplastic)) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: 15 kits per 30 day(s).
- Quantity Limit: limit maximum 10 ML PER 1 day(s)
- Diabetic Medical Supplies:
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: PA_APPLIES
|